Impact of clinical risk scores and BRAF V600E mutation status on outcome in papillary thyroid cancer

Niederer-Wüst, Séverine M.; Jochum, Wolfram; Förbs, Diana; Brändle, Michael; Bilz, Stefan; Clerici, Thomas; R, Oettli; Müller, Joachim; Haile, Sarah R.; Ess, Silvia; Stoeckli, Sandro J.; Broglie, Martina A.

doi:10.1016/j.surg.2014.07.015

Cited by 38 publications

(33 citation statements)

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“…did not find correlation of BRAF V600E mutation status with clinical risk scores and survival. [22] Henke et al . analyzed 506 patients with 70% mutation positivity but was not correlated with recurrence-free survival or DFS.…”

Section: Discussionmentioning

confidence: 99%

Lack of association of B-type raf kinase V600E mutation with high-risk tumor features and adverse outcome in conventional and follicular variants of papillary thyroid carcinoma

Nair

Babu

Biswas

et al. 2017

Indian J Endocr Metab

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Introduction:Somatic B-type Raf kinase (BRAF) V600E mutation in exon 15 was frequently found in high frequencies associated with papillary thyroid cancer (PTC). The phenotype of these cancers expressed aggressive clinical and pathological features. The present study aimed to assess the prevalence of BRAF V600E mutation among conventional and follicular variants of PTC and its association with aggressive tumor factors and outcome.Study Design:Patients who were operated and received further treatment for PTC during 2012 were included in the study. BRAF V600E mutation analysis was done by extracting genomic DNA from tumor tissue.Results:Of the 59 patients included in the study, 51% harbored BRAF V600E mutation, but the mutation status was not associated with aggressive tumor factors and adverse outcome.Conclusion:BRAF V600E mutation was not significant predictor of aggressive tumor behavior in conventional and follicular variants of PTC.

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Section: Discussionmentioning

confidence: 99%

Lack of association of B-type raf kinase V600E mutation with high-risk tumor features and adverse outcome in conventional and follicular variants of papillary thyroid carcinoma

Nair

Babu

Biswas

et al. 2017

Indian J Endocr Metab

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“…This association remained significant after adjustment for tumor size, extrathyroid extension, lymph node metastases, and multifocality. Despite these findings, prospective data on the role of BRAF testing are still lacking, and the surgical literature is replete with evidence that preoperative BRAF testing is not cost effective, does not alter surgical decision making, and does not provide better prognostic information than current clinical staging systems …”

Section: Discussionmentioning

confidence: 99%

“…Despite these findings, prospective data on the role of BRAF testing are still lacking, and the surgical literature is replete with evidence that preoperative BRAF testing is not cost effective, does not alter surgical decision making, and does not provide better prognostic information than current clinical staging systems. [32][33][34][35][36] The V600E mutation is more commonly identified in particular subtypes of PTC, including the tall cell variant (77% vs 66% in conventional PTC), which is thought to have a more aggressive course. [37][38][39][40] FVPTCs, follicular neoplasms (FN), and Hurthle cell neoplasms lack BRAF mutations.…”

Section: Discussionmentioning

confidence: 99%

Use of BRAF v600e immunocytochemistry on FNA direct smears of papillary thyroid carcinoma

Wobker

Kim

Hackman

et al. 2015

Cancer Cytopathology

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BACKGROUND: Mutations of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) are identified in almost half of all papillary thyroid carcinomas (PTCs). These mutations are specific for PTC and may confer a worse prognosis. An immunohistochemical (IHC) stain for BRAF is commercially available and has been validated in surgical specimens. Fine-needle aspiration (FNA) is frequently used as a diagnostic tool for risk stratification of thyroid nodules. Therefore, the authors evaluated the performance of immunostaining with the anti-BRAF antibody VE1 on FNA direct smears. METHODS: The authors identified 51 FNA specimens that had subsequent surgical resection specimens with a diagnosis of PTC. BRAF VE1 IHC was performed on the surgical specimens to determine their mutation status. The corresponding direct smears were then stained using the same VE1 stain to assess correlation. RESULTS: Twenty-two of the 46 included surgical specimens were positive for BRAF mutations (47.8%) by IHC, consistent with the published rates. The paired cytologic smears from these cases revealed 65.3% concordance. The overall sensitivity of BRAF staining on cytologic smears was 63.6%, and the specificity was 58.3%. Concordance rates were highest in specimens that were diagnosed as malignant or suspicious for malignancy (75% and 85.7%, respectively). The negative predictive value increased to 77.8% when suspicious for follicular neoplasm/suspicious cases were combined. CONCLUSIONS: Specimens that were malignant or suspicious on FNA were most likely to be BRAF concordant. Limitations to the interpretation of smears included low cellularity and obscuring blood, macrophages, or colloid. With further refinement, it is possible that BRAF immunocytochemistry can be applied prospectively to thyroid FNAs for risk stratification and to reduce false-negative rates. Cancer (Cancer Cytopathol) 2015;123:531-9.

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“…The BRAF mutation is associated with aggressiveness of PTC [21-23]. Thus, planning the surgical extent of PTC must be carefully considered.…”

Section: Discussionmentioning

confidence: 99%

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

Lee

Hwang

et al. 2017

Clin Exp Otorhinolaryngol

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ObjectivesThe aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE.MethodsWe analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated.ResultsTumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively.ConclusionExcluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.

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Impact of clinical risk scores and BRAF V600E mutation status on outcome in papillary thyroid cancer

Cited by 38 publications

References 50 publications

Lack of association of B-type raf kinase V600E mutation with high-risk tumor features and adverse outcome in conventional and follicular variants of papillary thyroid carcinoma

Lack of association of B-type raf kinase V600E mutation with high-risk tumor features and adverse outcome in conventional and follicular variants of papillary thyroid carcinoma

Use of BRAF v600e immunocytochemistry on FNA direct smears of papillary thyroid carcinoma

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

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